Background: Non-united extra-articular proximal tibial fractures may be due to distraction, soft tissue interposition, poor vascular supply, or excessive malalignment. The aim of this study was to evaluate the double fixation and iliac bone graft for treatment of such condition.
Methods: This study included 15 adult patients with the mean age 37.9±5.2 years with non-united extra-articular proximal tibial fractures that were initially fixed by single implant (plate or nail). 60% of cases were open fracture and 80% of cases had a comminuted fracture. In cases without implant failure (3 cases with IMN, 3 cases with single lateral plate), an additional medial plate was added as a supplementary fixation. In cases with implant failure (9 cases with single lateral plate); removal of the failed implant, fixation with lateral locked plate and an additional medial plate were done. In all cases, iliac cancellous bone graft was done. The mean follow up period was 27±4.3 months.
Results: There were 73.3% excellent and 26.7% good outcome according to Johner and Wruhs’ criteria, with mean knee ROM was 123°. All fractures united solidly after a mean period of 21±2.7weeks. The mean time to full, unprotected weight bearing was 18±2.9 weeks. Two cases had a superficial infection, and one case had discomfort over the medial plate.
Conclusion: Double fixation construct and iliac bone graft had a satisfactory radiological and functional outcome for treatment of non-united extra-articular proximal tibial fractures. |
